NHS App successfully tested by more than 3,000 patients

NHS Digital has published findings from research carried out during the pilot phase of the NHS App.

Back in late 2017, the NHS announced that it wanted to help all patients in carrying out a series of important tasks through the use of an app. Since then a team of staff from NHS Digital and NHS England has been working to develop, build and test the NHS App. The pilot phase took place from September to December last year.

A total of 34 GP practices invited patients to take part in the pilot by text message or email. Patients had to complete a short survey to determine their suitability for the pilot. Patients were then emailed a link to download a test version of the app.

The NHS App was released to app stores on 31 December 2018. Currently, GP practices across England are being connected gradually to it. All functions of the app are scheduled to be fully available across England by July 2019.

The pilot was an important milestone for the development team and highlighted a number of areas of work needed to improve the app for users. Further to this, the team has also developed its capacity to fix bugs and resolve issues quickly if necessary.

The app underwent an independent assessment to ensure it worked for people with limited vision, communication and motor skills. It achieved Web Content Accessibility Guidelines (WCAG) 2.1 AA rating, with recommendations for further improvements. This means the NHS App has been rated as having a high standard of accessibility.

The good, the bad and the ugly

The pilot indicated that users were enthusiastic for the look and feel of the NHS App. It also indicated that the users appreciated having access to a reliable Health A – Z feature to check a condition.

During the pilot, most users said they used the app for viewing their medical record. Ordering repeat prescriptions and booking appointments were the next. Cancelling appointments and setting data sharing preferences were the two least used services. Users rated ordering repeat prescriptions as the most useful service on the app, followed by viewing the medical record.

The following emerging themes were identified from the user feedback.

1. The design of the NHS App is good and it’s easy to navigate: 64% of users told us that the NHS App was the first app they had downloaded that was paired with their NHS number and medical record at their GP practice.
2. Two-factor authentication was an annoyance: Users were unsure why this was necessary each time they wanted to log in to the NHS App and felt it was an extra step that did not add much security.
3. Appointment names could be hard to understand: At nearly all practices, less than half of users were able to understand the names of the appointments displayed in the app.
4. Appointment availability did not always meet expectations: Some users were disappointed with the appointment slots that were available for booking and had expected more options. Others were frustrated that their specific doctor was not available.
5. Medical record access was great if you had the right level of access: 49% of patients that completed our survey thought the amount of information they could see in their record was sufficient. 52% said they could see what they were looking for.
6. The medical information accessible via the app was good: 63% of users said they found the Health A-Z a useful symptom-checking service. 87% of users said they were able to find all the information and advice that they were looking for.
7. Ordering a repeat prescription was quick and convenient: 87% of users said they found ordering a repeat prescription easy and convenient.

Practices need to be engaged early and clearly

Josh Dresner, a user researcher for the NHS App, said: “For the practices, the aim was to have no significant impact and to reduce the burden of signing people up for online services. With our pilot, we found that practice staff needed to learn about the app in order to promote it, but after sending an initial SMS to invite patients and the few queries that followed, there wasn’t much change. We’re working with the feedback we’ve received in order to improve practices’ onboarding experience and overall setup over the coming months.

“This is the very beginning of the NHS App journey. Integration with the wider GP system and promotion to patients will take further focused user-centred design and collaboration over the coming months. We will update again as we increase our user numbers from the thousands to hundreds of thousands in 2019.”

The pilot showed that practices need to be engaged early and clearly. Appointment naming and availability need to be looked at by the practices before being connected to the app. Patients must have a positive experience in the app from the first time they download it. The toolkit developed for practices going live with the app will help ensure this happens.

The NHS has already embarked on its digital journey. A couple of months ago, the NHS decommissioned pagers and announced that it would soon upgrade them with mobile technology.